Multicentric prospective and descriptive study about community-acquired methicillin-resistant Staphylococcus aureus cutaneous and soft tissue infection (CA-MRSA)

Resumen

Abstract

Community acquired methicillin-resistant Staphylococcus aureus is one of the main emergent pathogens of the last decade, being the first cause of skin and soft tissue infections in some countries. The purpose of this study is to describe the epidemiologic, clinical, and microbiological
characteristics of CA-MRSA cutaneous and soft tissue infections in an ambulatory setting.
Methods. We conducted a multuicentric, prospective, descriptive study performed in 6 dermatology units at Buenos Aires from july 2008 to june 2009. Patients with documented CA-MRSA skin and soft tissue infections were included. Community acquisition was defined based on epidemiologic criteria.
Results. We included 114 patients, of which 49% were male and 51% were female. The median age was 27 years. Seventy four percent of the patients had received beta-lactamic antibiotic treatment
prior to inclusion. The main clinical presentation were furuncules (59%) followed by abscesses (20%). The most frequently prescribed antibiotic was trimethoprim-sulfametoxazole (68,4%). The most frequently recovered isolates were erithromicin- (21,7%) and clindamycin-resistant (16,2%). Six patients required hospital admission, 18 had recurrent diseases, and no death was recorded.

Discussion. Demographic and clinical data obtained in this study are similar to those previously reported. Most of the patients had received antibiotic treatment before inclusion, which shows the low CA-MRSA clinical suspicious. Impetigo was frequently observed among children, and cellulitis was exclusively observed in females. As clindamycin resistance was higher than 15%, this antibiotic should not be considered a first-line treatment option. CA-MRSA infections were frequently observed in our patients, therefore its diagnosis should be considered on suppurative lesions and non responding pyodermitis

(Dermatol Argent 2010;16(2):110-116).

Keywords: community acquired methicillin resistant Staphylococcus ureus.